bird flu
revere | January 24, 2007Bird flu is a disease of birds, so how are the birds doing this year? If you just read the headlines, you might be a bit confused. Unfortunately reading the stories won't clear things up:
Many global bird flu outbreaks unreported -FAO
Many countries are doing a better job fighting the H5N1 bird flu virus, yet many outbreaks are not reported, Food and Agriculture Organisation (FAO) officials said on Tuesday.
[snip]
"So far, many countries have managed to progressively control the virus and the global situation has improved tremendously," Juan Lubroth, a senior FAO infectious diseases official…
revere | January 23, 2007Dr. Margaret Chan has been on the job at WHO for about a month. So far so good. Two weeks ago she named Dr. Anarfi Asamoa-Baah as WHO's Deputy-Director General. I don't know him, myself, but those who do (and whose judgment I trust) have nothing but the highest praise for him, describing him as "brilliant." This is generally thought of as a wise and effective move. One appointment doesn't make a successful tenure, but I'd rather be giving provisional approval than complaining about something.
Dr. Chan's statements on bird flu, while not startling, are at least accurate. Monday she addressed…
revere | January 22, 2007A little noticed paper in CDC's Emerging Infectious Diseases takes us back to a year ago when dead and dying birds infected with H5N1 were first found near water in Germany, Slovenia and Austria. In mid February 2006 a sick swan picked up from a river in Austria was taken to an animal shelter in Graz. It died a day later. While there it infected 13 of 38 other birds (swans, ducks and chickens), detected 3 days later. That day the poultry area of the shelter was disinfected after the birds were removed.
But the animal shelter had more than birds:
In the same shelter were 194 cats; most had…
revere | January 19, 2007The news that H5N1 viruses isolated from an uncle and niece in Egypt who died in December has been found to carry a genetic change suggestive of resistance to the main antiviral drug oseltamivir (Tamiflu) headlined the H5N1 newswires yesterday. Specifically, WHO announced that genetic sequencing had found the N294S change in the isolates (explanation below the fold). It is not clear at the moment whether the change occurred during treatment of the pair with the drug or the virus carried the change when it infected them. It is also not clear what the clinical significance of the change is. We…
revere | January 18, 2007It may not be the most comforting headline, but it certainly is of interest to flu watchers: Rebuilt 1918 Flu Infects Monkeys, May Assist Research (John Lauerman, Bloomberg). It's also a pretty accurate headline. Nice to see. So what's it all about?
Most people who come here know that the 1918 "Spanish flu" virus has been reconstituted, using information frm fragments of the viral genetic material dug up from frozen corpses in Alaska, Siberia and pathology samples kept in archives. Once the entire sequence was pieced together the actual genetic material could be constructed and allowed to…
revere | January 17, 2007Two news reports in recent days added another dimension to the already worrisome seasonal resurgence of H5N1. First, there is little doubt that the current spate of human cases is just what we expect to see at this time of year, based on past experience. This doesn't mean that the increase is "just" seasonal, however. It can easily be masking or being accompanied by a change in the virus that makes this year different than last year, just as perhaps previous years were different than the ones before. To say this is a the usual seasonal resurgence is more descriptive than explanatory. It is…
revere | January 16, 2007It's January and once again the bird flu news is unsettling. Reports from Indonesia suggest a new cluster there and one of the isolation wards to be used for suspected bird flu cases is reported to be overwhelmed, although the small number of beds in these facilities doesn't mean huge numbers. Enough to be concerned, though. Another story says that the virus is prevalent in feral cats in Indonesia. That has yet to be confirmed. Besides the list we noted yesterday, Thailand is now reporting a poultry outbreak. Given all this, I continue to be cautious about how to interpret the January bad…
revere | January 15, 2007Michael Fumento is piqued because nobody paid any attention to his ludicrous and childish dare to us, DemFromCT at DailyKos and Tim Lambert and MadMike here at SciBlogs:
Okay guys, put your bucks where your blogs are! Ten to one odds for each of you; each gets to pick the amount in question. I say the year 2008 will roll around and there will be plenty of terrible problems in the world, but pandemic avian flu won't be among them. Naturally some of these anti-scientists have insinuated that somebody must be paying me to say pandemic avian flu is a bunch of bird droppings -- that's also how the…
revere | January 14, 2007Six days ago when commenting on the first human case in Indonesia for 6 weeks, we noted that flu season was upon us and to expect more. That's seems to be the way it is working. The virus continues to spread in poultry in Vietnam and outbreaks have been confirmed in Nigeria, Japan and South Korea. The new year also saw human cases in Korea and one in December in China and three in Egypt. Now Indonesia seems to be reporting them almost daily, four in the last week. There is talk of a cluster, there. So what's going on?
There are two main possibilities, neither of them good but one much worse…
revere | January 12, 2007There once was a nice tidy story about why avian influenza viruses infected birds and human influenza viruses infected humans and pigs were the "mixing vessel" that brought them together so they could reassort their genetic innards. It went something like this. The avian virus can only attach to and thus infect cells that have a specific kind of receptor on their surface. The receptor was a terminal sialic acid with a particular linkage to the underlying cellular glycoprotein (for more on this see our four part primer on glycoproteins beginning here). For birds the linkage was designated α2,…
revere | January 11, 2007Reader K (hat tip) sent along the link to a New Yorker cartoon which seems the ideal accompaniment to this small squib from the MSN financial column, Ahead of the Bell: Bird Flu:
NEW YORK (AP) - Bird flu concerns swooped back into the news Wednesday, bringing companies trying to find treatments for the deadly virus back into focus.
The H5N1 bird flu virus typically spreads during traditional flu season as temperatures drop in winter months. The virus is transmitted mostly among birds, but has transferred to humans who are in close contact with them, and health officials fear the H5N1 strain…
revere | January 11, 2007From yesterday's Jakarta Post:
No extraordinary measures against bird flu this year
JAKARTA (JP): Coordinating Minister for Social Welfare Aburizal Bakrie said Wednesday the government would not take any extraordinary measures against bird flu this year.
Aburizal said the current measures were sufficient to contain the spreading of bird flu in the country.
"We have been applauded by international agencies for our measures to handle the bird flu in the country," he said in a press conference.
A-14-year-old boy died in a hospital in Jakarta on Wednesday after being confirmed to be infected with…
revere | January 10, 2007Yesterday Canada's Campbell commission released its report on the 2003 SARS outbreak in Toronto. SARS is most infectious in the latter part of its disease course, so it isn't surprising that 45% of the victims were health care workers. Two nurses and a doctor died. SARS was a deadly occupational disease.
In the 1200 plus page report, Judge Campbell and his colleagues place the blame on a broken health care system but find no individuals at fault. The Toronto Globe and Mail is disappointed. My initial reaction was irritation they saw a need for scapegoats, but as I read the column by Murray…
revere | January 9, 2007I just returned from our University bird flu task force. We aren't ready. We aren't even close. The good news is that we know we aren't ready and we know we aren't even close. At least we're worried. This isn't some penny ante crowd of mid level managers, either. These are the top dogs at one of the biggest private universities in the country. They take it seriously. But it's tough. Our community is larger than many small cities but not as self sufficient. But if it's the planning and not the plan, we've made progress, because we're meeting regularly although we still don't have a plan.
That…
revere | January 8, 2007The major H5N1 news over the weekend was the new Indonesian case, their first confirmed human case of 2007. The major H5N1 news of the end of the year was the absence of any human cases in Vietnam. The Indon case has been well covered on the newswires. It's a 14 year old boy, hospitalized on New Year's Day. He is said to have had contact with a dead duck. On the other hand, they always say something like that in Indonesia. Their previous case was five weeks earlier. But it's winter and flu season. Expect more.
Now, Vietnam. First, after no reported outbreaks in poultry for over a year, the…
revere | January 7, 2007The vexing problem of when to close schools in the event of an influenza pandemic and who will do it seems to be, well, still vexing. A brief communication in CDC's journal Emerging Infectious Diseases by Princeton's Laura Kahn makes clear the level of vagueness, if not confusion surrounding it in the US:
The US Department of Health and Human Services' checklist regarding school closures gives conflicting messages. For example, it recommends that schools stay open during a pandemic and develop school-based surveillance systems for absenteeism of students and sick-leave policies for staff and…
revere | January 5, 2007Since I started cogitating on the apparent dominance of H1 subtypes this flu season instead of the more common H3, I've continued to look at some previous papers on the subject. The take home message I am getting is that there is quite a bit we don't know about this disease, influenza, despite its long history and the interest of the medical and scientific community. We've commented on this before. Some problems are like that. Cancer is another example. A particularly interesting paper that illustrates the point by Hay et al. was published in 2002 (hat tip to a loyal reader who sent the link…
revere | January 4, 2007One of the unanswered questions about the transmission of influenza H5N1 is the mode. We presume, probably correctly, that person to person spread is the main mode, mediated by coughing, breathing, sneezing. Whether the infective material is small enough to remain suspended in the air for long periods or whether it is primarily in large droplets that settle out quickly is a matter of importance still under debate but both possibilities pertain to person to person spread via the respiratory tract. Then there is the question of the role of inanimate objects, like door knobs, arm rests or…
revere | January 3, 2007The other day we observed that through week 51 of 2006 (two weeks ago) flu activity in the US looked about "normal" except for the dominance among subtyped isolates of H1 influenza instead of the more usual H3. I began to wonder how common or uncommon this was and have done a little digging, but haven't found all the information I am looking for yet concerning the relative dominance of H3 versus H1 in the years since 1977, which is when H1 made its reappearance. Data on CDC's flu activity website regarding subtypes only goes back to 2000 - 2001 (at last that I could find), and that is also…
revere | January 2, 2007Crawford Kilian at the H5N1 blog makes the pertinent observation that the reports of suspected human bird flu in Vietnam have gone into a kind of limbo. He refers to it as "information inertia" because the same reports of the four suspect cases (and possibly two more) have been co-circulating for days with a single Agence France Presse report that further testing on four of the cases are negative. Both reports appear essentially unchanged on successive dates. Crawford speculates it may be related to short staffing over the holidays failing to catch up with the latest news the cases are not…